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8/13/2019 Insect Sting and Snake Bites
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SN KE BITESVenomous snake bites are medical emergencies.
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Children between 1-9 years old are themost common victims.
Greatest number of bites occurs duringthe daylight hours and early evenings ofsummer.
Most common site: upper extremity Pit vipers-most frequent poisonous
snake biters.
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Clinical Manifestations
Edema
Ecchymosis
Hemorrhagic bullae
Symptoms: lymph node tenderness,nausea & vomiting, numbness,metallic taste in the mouth
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Management Initial first aid:
-have the person lie down.
-remove constrictive items
-provide warmth
-cleanse and cover thewound with light dressing
-immobilize the injuredpart below the level of theheart
-check ABC.-DO NOT apply ice or
tourniquet to the injuredsite.
There is no specificprotocol for thetreatment of snake
bites. Parenteral fluids are
used to treathypotension.
The patient isobserved closely for6hours.
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Administration of Antivenin An antitoxin used to treat snake bites.
Should be administered within 4 hours after the snakebite.
2 kinds:
A. Antivenin Polyvalent (ACP)
B. Crotalidae Polyvalent Immune Fab Antivenin (FabAV) Perform skin or eye testto detect hypersensitivity to
antivenin.
Before administering antivenin and every 15 mins, thecircumference of the affected part is measured.
Premeds (dipenhydramine or cimetidine) are indicatedto decrease allergic response.
Administered through IV infusion.
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Initial Evaluation in the ED
If the snake is venomous or nonvenomous
Where and when the bite occurred and itscircumstances.
Sequence of events and S/S
Severity of poisonous effects VS
Circumference of the injured site
Lab. Data ( CBC, urinalysis and coagulationstudies)
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Insect Stings
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an extreme sensitivity to thevenoms of insects (orderHymenopter
bees hornets yellow jackets fire ants Wasps
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Venom allergy IgE-mediatedreaction and it constitutes anacute emergency
can trigger anaphylaxis stings of the head and neck or
multiple stings are serious
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Clinical manifestations generalized urticaria itching
malaise
anxiety due to laryngeal edema tosevere bronchospasm
shock
death
Generally, the shorter the timebetween the sting and the onset ofsevere symptoms, the worse theprognosis
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Management
stinger removal .The stinger isremoved with one quick scrape of afingernail over the site.
Wound care with soap and water issufficient for stings.
**Scratching is avoided because itresults in a histamine response.
Ice application reduces swelling andalso decreases venom absor tion.
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An oral antihistamine andanalgesic will decrease the itchingand pain
Desensitization therapy should begiven to people who have hadsystemic or significant localreactions.
Patient and family education is animportant measure in preventingexposure to stinging insects
Recommended